Doctors tout advance in early detection of Breast Cancer

The cornerstone in the fight against breast cancer is early detection. The cornerstone of early detection is imaging.

By Katrina Powell/Corresponde

Wicked Local

By Katrina Powell/Corresponde

Posted Oct. 21, 2011 at 12:01 AM
Updated Oct 21, 2011 at 9:08 PM

By Katrina Powell/Corresponde

Posted Oct. 21, 2011 at 12:01 AM
Updated Oct 21, 2011 at 9:08 PM

Danvers

» Social News

The cornerstone in the fight against breast cancer is early detection. The cornerstone of early detection is imaging.

This is how radiologist Dr. Elizabeth Rafferty began her discussion on the advances of imaging, a medical technique used for breast cancer detection. Rafferty spoke passionately to an audience composed mainly of women, during a lecture on the advances in breast health, held at Mass General/North Shore Center for Outpatient Care on Tuesday, Oct. 11.

Throughout her presentation, Rafferty, the director of breast imaging at the Avon Comprehensive Breast Center at Mass General in Boston and in Danvers, affirmed her belief that early detection is essential and that the use of imaging, combined with regular mammograms and other tools for detection, may allow for doctors to make a timely diagnosis.

“There is almost universal agreement that the randomized controlled trials of screening have demonstrated that the death rate from breast cancer can be reduced by periodic screening using mammography,” Rafferty said. “[But] as many as 20 percent of breast cancers will be missed by mammography.”

Rafferty said imaging can increase the cancer detection rate. Imaging involves the use of computerized techniques and instruments to obtain pictures of the interior of the body, especially soft tissues such as the breast. Rafferty said tomosynthesis is an effective imaging method for detection.

Tomosynthesis is a three-dimensional mammography examination, used to minimize the effects of structure overlap within the breast, which results in improvements in both sensitivity and specificity from mammography. This technology is seen as an advance in cancer detection by doctors because of the ability to increase lesion visibility, analyze the extent of the disease and pinpoint the precise location of the lesion.

According to Rafferty, with conventional mammograms, an X-ray source remains stationary in a position that is perpendicular to the compressed breast, which is placed on top of a detector. X-rays pass through the breast and strike the detector, which captures the information and creates an image.

With tomosynthesis, an X-ray moves through a proscribed arc of excursion, acquiring multiple images during a four-second sweep, which gives a more comprehensive picture of the interior of the breast, Rafferty said.

Rafferty said other techniques such as computer-aided detection and MRI’s could also be helpful in detecting breast cancer early on.

“In over 20 studies, computer-aided detection has shown the ability to increase the cancer detection rate of radiologists,” Rafferty said.

Rafferty added that digital mammography does offer a cancer detection benefit for specific subgroups of women such as women less than 50 years of age, women who are both pre- and peri-menopausal, and women with dense or heterogeneously dense breast tissue.

Breast Cancer is common

According to Dr. Erica Linden, an oncologist who practices out of the Mass General/North Shore Cancer Center in Danvers, breast cancer is the second leading cause of cancer death in women. Worldwide, Linden estimated that there were 1.3 million diagnoses in 2008, and 458,000 deaths related to the disease.

Page 2 of 3 - In the United States, the American Cancer Society estimated that by the close of 2011, 39,520 women will have died from breast cancer. While those numbers seem high, Linden said the death rates have been decreasing since 1990, which she attributed to early detection and the advancements in technology and treatments.

While it may seem as if the odds are against women, the opposite is true, as Linden explained that there are more than 2.6 million breast cancer survivors in the United States. Linden said there are several ways for women to engage in preventative behavior that will effectively lower the risk of breast cancer.

Linden said in looking at a woman’s risk factor, it is important to understand the two types of risks: non-modifiable risks, which are factors that cannot be changed and modifiable risks, which are factors that can be changed. According to Linden, the non-modifiable risks of breast cancer include:

Pagination please bullet

· Being female

· Age

· Genetics

· Family history of breast cancer

· Prior breast cancer diagnosis

· Race and ethnicity—highest incidence in white, non-Hispanic women, African American women under 40 have a higher risk and their mortality rate is higher

Linden said all of the prior factors increase a woman’s chance of being diagnosed with breast cancer, but they cannot be changed. Linden encourages women to instead focus on the modifiable risks of breast cancer, the factors that women can change, and therefore decrease their chances of being diagnosed with breast cancer. She said the modifiable risks of breast cancer include:

Linden said women who have their first child after the age of 30, or no children at all, are more likely to have breast cancer. However, having many pregnancies or delivering at an earlier age decreases a woman’s risk. Also, breast-feeding for one to two years decreases a woman’s risk.

Linden said women who have used an oral contraceptive within the past 10 years have a higher risk, as do women who gain excess weight as adults. In fact, a woman’s risk increases by 30 percent when she is overweight, Linden said.

Linden said multiple studies have demonstrated a relationship between alcohol intake and breast cancer. Moderate alcohol intake — consumption of between three and 14 drinks per week — increases a woman’s risk factor. Lack of physical activity can also be a risk factor, Linden said.

Page 3 of 3 - In order to take action to prevent breast cancer, Linden advises women to consume fewer than five alcoholic beverages per week, exercise five days per week for 45 to 60 minutes, take part in screening and evaluate the need for genetic testing, have children prior to age 30 and breast-feed their infants.